Hsa_circRNA_063981作为2型糖尿病诊断标志物的初步研究

目的 分析Hsa_circRNA_063981在2型糖尿病（type 2 diabetes mellitus,T2DM）患者中的表达情况,了解其与临床指标和炎症因子的相关性。方法 选取2021年5月至10月于浙江省诸暨市人民医院就诊的40例T2DM患者纳入T2DM组,选取同期40名健康体检者纳入对照组。比较两组受试者的一般临床资料、Hsa_circRNA_063981和白细胞介素-6（interleukin-6,IL-6）的表达水平,Pearson相关性分析Hsa_circRNA_063981与临床指标和炎症指标的相关性,绘制受试者操作特征曲线评估Hsa_circRNA_063981诊断T2DM的潜在价值。结果 T2DM组患者的体质量指数、收缩压、舒张压、空腹血糖、糖化血红蛋白、空腹C肽均显著高于对照组,空腹胰岛素显著低于对照组（P<0.05）。T2DM组患者的Hsa_circRNA_063981、IL-6表达均显著高于对照组（P<0.05）。Hsa_circRNA_063981与空腹胰岛素水平呈正相关（r=0.397,P=0.011）,与IL-6无相关性。Hsa_circRNA_063981诊断T2DM患者的曲线下面积为0.610,敏感度和特异性分别为33.3%和87.23%。结论 Hsa_circRNA_063981对T2DM具有一定的诊断价值。     

基于迁移学习的2型糖尿病风险预测方案设计

提出了一种基于迁移学习的2型糖尿病风险预测方案,使用2型糖尿病发病相关危险因素作为原始糖尿病预测建模特征,对原有的糖尿病风险预测模型进行了优化,帮助医疗欠发达地区通过该模型实现对2型糖尿病的有效监测和防护.     

2型糖尿病病人微量白蛋白尿的危险因素分析

目的　研究 2型糖尿病患者微量白蛋白尿 (MAU)的危险因素。方法　用放射免疫法测定 3 2 8例 2型糖尿病病人尿白蛋白排泄率 (UAER)。同时测定血压、血糖、血脂等。结果　两组病人在空腹血糖 (FBG)、餐后 2h血糖 (2hBG)、甘油三酯 (TG)、舒张压 (DBP)、糖化血红蛋白 (HbAlc)指标差异均无显著性 (P >0 .0 5 )。而收缩压 (SBP)、总胆固醇(TC)比较差异有高度显著性 (P <0 .0 1)。结论　血压控制不良将导致 2型糖尿病病人MAU。     

2型糖尿病大鼠心血管风险相关生物标志物的变化研究

以小剂量链脲佐菌素(STZ)诱导的2型糖尿病大鼠为实验模型,研究2型糖尿病大鼠糖代谢、脂代谢及心血管风险相关生物标志物的变化趋势和相互关系。将实验动物分为空白对照组、高脂对照组和2型糖尿病组,分别于注射STZ造模前和造模后第2、4、7、9周空腹取血,测定血液中糖、脂代谢生物标志物、不对称二甲基精氨酸(ADMA)、总同型半胱氨酸(tHcy)、脂联素(APN)和正五聚蛋白3(PTX₃)浓度。结果表明,2型糖尿病组空腹血糖、胰岛素抵抗指数、甘油三酯、总胆固醇、低密度脂蛋白胆固醇显著高于空白对照组和高脂对照组。与空白对照组相比,2型糖尿病组ADMA逐渐升高,tHcy逐渐降低,APN显著降低,PTX₃显著升高。2型糖尿病大鼠与心血管风险相关的生物标志物ADMA、tHcy、APN、PTX₃与糖、脂代谢生物标志物之间存在密切的相关性,在评价其心血管风险时应同时监测上述多个生物标志物。     

Long-term beta-carotene supplementation and risk of type 2 diabetes mellitus: a randomized controlled trial.

CONTEXT: Recent data suggest a protective role of carotenoids in the development of type 2 diabetes mellitus (DM), possibly via an antioxidant effect, but no randomized trial has directly assessed the efficacy of beta-carotene to prevent DM. OBJECTIVE: To determine whether long-term beta-carotene supplementation reduces the risk of developing type 2 DM. DESIGN, SETTING, AND PARTICIPANTS: A total of 22, 071 healthy US male physicians aged 40 to 84 years in a randomized, double- blind, placebo-controlled trial, from 1982 to 1995. More than 99% of the participants had complete follow-up (median duration, 12 years). INTERVENTION: Subjects were randomly assigned to receive beta-carotene (50 mg on alternate days) or placebo. MAIN OUTCOME MEASURE: Incidence of type 2 DM. RESULTS: A total of 10, 756 subjects were assigned to beta-carotene and 10, 712 to placebo. Incidence of type 2 DM did not differ between groups: 396 men in the beta-carotene group and 402 men in the placebo group developed type 2 DM (relative risk, 0.98; 95% confidence interval, 0.85-1.12). The lack of association between beta-carotene supplementation and incidence of type 2 DM persisted despite multivariate adjustment. There was no evidence of benefit when the period of risk was subdivided into years of follow-up or increasing duration of treatment. CONCLUSION: In this trial of apparently healthy men, supplementation with beta-carotene for an average of 12 years had no effect on the risk of subsequent type 2 DM.     

Serum galectin-3: a risk factor for vascular complications in type 2 diabetes mellitus

Background Plasma galectin-3,a mediator of fibrogenesis and inflammation,its potential to associate with type 2 diabetes (T2DM) is poorly investigated.Here,we explored its interaction with the serum ga...     

Biomarkers of endothelial dysfunction and risk of type 2 diabetes mellitus

Context  Endothelial dysfunction occurs in diagnosed type 2 diabetes mellitus but may also precede development of diabetes. Objective  To determine whether elevated plasma levels of biomarkers reflecting endothelial dysfunction (E-selectin; intercellular adhesion molecule 1 [ICAM-1]; and vascular cell adhesion molecule 1 [VCAM-1]) predict development of type 2 diabetes in initially nondiabetic women. Design and Setting  Prospective, nested case-control study within the Nurses' Health Study, an ongoing US study initiated in 1976. Participants  Of 121 700 women initially enrolled, 32 826 provided blood samples in 1989-1990; of those free of diabetes, cardiovascular disease, or cancer at baseline, 737 developed incident diabetes by 2000. Controls (n = 785) were selected according to matched age, fasting status, and race. Main Outcome Measure  Risk of confirmed clinically diagnosed type 2 diabetes by baseline levels of E-selectin, ICAM-1, and VCAM-1. Results  Baseline median levels of the biomarkers were significantly higher among cases than among controls (E-selectin, 61.2 vs 45.4 ng/mL; ICAM-1, 264.9 vs 247.0 ng/mL; VCAM-1, 545.4 vs 526.0 ng/mL [all P values .004]). Elevated E-selectin and ICAM-1 levels predicted incident diabetes in logistic regression models conditioned on matching criteria and adjusted for body mass index (BMI), family history of diabetes, smoking, diet score, alcohol intake, activity index, and postmenopausal hormone use. The adjusted relative risks for incident diabetes in the top quintile vs the bottom quintiles were 5.43 for E-selectin (95% confidence interval [CI], 3.47-8.50), 3.56 for ICAM-1 (95% CI, 2.28-5.58), and 1.12 for VCAM-1 (95% CI, 0.76-1.66). Adjustment for waist circumference instead of BMI or further adjustment for baseline levels of C-reactive protein, fasting insulin, and hemoglobin A_1c or exclusion of cases diagnosed during the first 4 years of follow-up did not alter these associations. Conclusion  Endothelial dysfunction predicts type 2 diabetes in women independent of other known risk factors, including obesity and subclinical inflammation.      

2型糖尿病患者颈动脉粥样硬化斑块形成的危险因素分析

目的探讨2型糖尿病患者颈动脉粥样硬化斑块(CAS)形成的危险因素。方法选择109例2型糖尿病患者,根据颈动脉超声结果分为斑块组(54例)和非斑块组(55例),记录两组患者的年龄、吸烟史、高血压病史、糖尿病病程、体重指数(BMI)、颈动脉内中膜厚度(IMT)、糖化血红蛋白(Hb A1c)、低密度脂蛋白(LDL-C)、总胆固醇(TC)、尿酸(UA)以及C反应蛋白(CRP)水平,并进行统计学分析。结果斑块组患者年龄、吸烟及高血压比例、糖尿病病程、IMT、LDL-C、TC、CRP及UA水平与无斑块组比较均有显著性升高(P﹤0.01或P﹤0.05);Logistic多元回归分析显示:年龄、高血压病史、糖尿病病程、LDL-C、CRP以及UA水平与CAS形成显著相关(P﹤0.01或P﹤0.05)。结论年龄、高血压病史、糖尿病病程、LDL-C、CRP以及UA升高是2型糖尿病患者CAS形成的独立危险因素。     

2型糖尿病的综合治疗

2型糖尿病传统的治疗理念以降血糖为核心,近年来多项大规模研究结果证实,综合治疗包括降血糖治疗、血压管理、他汀类调脂药物以及阿司匹林的应用,对于2型糖尿病的最终结果改善起到十分重要的作用.新兴的治疗手段胃减容手术在减重和血糖控制中的作用也逐渐得到关注.     

New treatments for patients with type 2 diabetes mellitus.

In subjects with type 2 diabetes, both defects of insulin secretion and insulin resistance contribute to the development of hyperglycaemia. The major goals of treatment are to optimise blood glucose control, and normalise the associated lipid disturbances and elevated blood pressure. Pharmacologic treatment is often necessary. This paper discusses new forms of oral treatment for subjects with type 2 diabetes. These include a new sulphonylurea compound glimepiride (Amaryl), which binds to a different protein of the putative sulphonylurea receptor than glibenclamide, and seems to have a lower risk of hypoglycaemia. A new class of drugs with insulin secretory capacity, of which repaglinide (NovoNorm) is the leading compound, is now in phase III clinical trials. Alpha-glucosidase inhibitors reversibly inhibit alpha-glucosidase enzymes in the small intestine, which delays cleavage of oligo- and disaccharides to monosaccharides. This leads to a delayed and reduced blood glucose rise after a meal. Two compounds are in development or have been marketed, ie, miglitol and acarbose (Glucobay). Another new class of drugs is the thiazolidine-diones, which seem to work by enhancing insulin action. The ''insulin sensitising'' effects of the leading compounds, troglitazone and BRL 49653C, do not involve any effect on insulin secretion. These drugs also seem to beneficially influence serum cholesterol and triglyceride levels. Oral antihyperglycaemic agents can be used only during a limited period of time in most patients, after which the diabetic state ''worsens'' and insulin therapy has to be started. In this light, two new forms of treatment which require subcutaneous injections are also discussed: the synthetic human amylin analogue AC137 (pramlintide) and glucagon-like peptide-1 (7-36)-amide, a strong glucose-dependent stimulator of insulin secretion. It remains to be seen whether these compounds can be developed further for clinical use in patients with diabetes.     

Assessment of risk for type 2 diabetes mellitus in a Caribbean population with high diabetes-related morbidity

Diabetes mellitus is a major cause of morbidity in Trinidad and Tobago. Screening programmes are not incorporated in the health sector and the population at risk remains unaware of the benefits of screening. We investigated the risk of developing Type 2 diabetes mellitus in office workers with one risk factor. Participants were randomly selected from the urban corporate sector in Port of Spain. Fasting capillary blood glucose and the American Diabetes Association (ADA) questionnaire for major diabetes risk factors were used to assess risk. Student pharmacists approached 482 persons, of whom 317 consented to participate (66% response rate). There were 101 (32%) men and 216 (68%) women, 37 (39%) were of African ancestry and 28% each were of East Indian and mixed ancestry. Family history was positive in 54%. Thirty per cent (95) of the volunteers were at risk of developing Type 2 diabetes mellitus (41 men; 54 women). Based on the ADA questionnaire, 82% (78) of volunteers were at high risk for developing Type 2 diabetes mellitus. The ADA risk test and Impaired Fasting Glucose were both positive in 13 (14%) volunteers. In subjects at risk, Body Mass Index (BMI) was > 25 kg/m2 in 74% (78) and the waist/hip ratio was 0.85. Approximately 30% of office staff was at risk of developing diabetes mellitus. The ADA questionnaire is a useful non-invasive measure which pharmacists can use to assess risk for Type 2 diabetes mellitus. The glucometer can be used for risk assessment providing that it is associated with a quality assurance programme and that diagnosis is confirmed with laboratory testing.     

老年2型糖尿病患者糖尿病视网膜病变相关因素分析

目的:探讨老年2型糖尿病患者糖尿病视网膜病变相关危险因素。方法:选择2008年5月～2011年6月在我院门诊及住院治疗的98例老年2型糖尿病患者,根据有无视网膜病变分为两组,其中糖尿病视网膜病变(DR)组48例,非糖尿病视网膜病变组50例,对两组的性别、年龄、病程、收缩压(SBP)、舒张压(DBP)、体重指数(BMI)、空腹血糖(FBG)、餐后2h血糖(PBG2h)、糖化血红蛋白(GH-bA1c)、C反应蛋白(CRP)、同型半胱氨酸(HCY)、尿酸(UA)和血脂等相关因素进行比较,DR与各种影响因素间相关性检验用Logistic多因素逐步回归分析。结果:糖尿病视网膜病变组年龄、病程、SBP、GHbA1c、CRP、HCY、UA以及LDL与非糖尿病视网膜病变组比较,差异有统计学意义(P<0.05～0.01);病程、SBP、GHbA1c、CRP及HCY 5个因素与DR发生密切相关(P<0.05)。结论:病程、SBP、GHbA1c、CRP及HCY是发生糖尿病视网膜病变的危险因素。     

Pathogenesis of type 2 diabetes mellitus

The pathological sequence for type 2 diabetes is complex and entails many different elements that act in concert to cause that disease. This review proposes a sequence of events and how they interact by a careful analysis of the human and animal model literature. A genetic predisposition must exist, although to date very little is known about specific genetic defects in this disease. Whether the diabetes phenotype will occur depends on many environmental factors that share an ability to stress the glucose homeostasis system, with the current explosion of obesity and sedentary lifestyle being a major cause of the worldwide diabetes epidemic. We also propose that a lowered beta-cell mass either through genetic and/or beta-cell cytotoxic factors predisposes for glucose intolerance. As the blood glucose level rises even a small amount above normal, then acquired defects in the glucose homeostasis system occur--initially to impair the beta cell's glucose responsiveness to meals by impairing the first phase insulin response--and cause the blood glucose level to rise into the range of impaired glucose tolerance (IGT). This rise in blood glucose, now perhaps in concert with the excess fatty acids that are a typical feature of obesity and insulin resistance, cause additional deterioration in beta-cell function along with further insulin resistance, and the blood glucose levels rise to full-blown diabetes. This sequence also provides insight into how to better prevent or treat type 2 diabetes, by studying the molecular basis for the early defects, and developing targeted therapies against them.     

AGE预测2型糖尿病患者肌少症发生风险

目的 分析2型糖尿病（type 2 diabetes mellitus,T2DM）患者发生肌少症的危险因素,建立列线图预测模型探讨糖基化终末产物（advanced glycation end product,AGE）预测T2DM患者肌少症的患病风险。方法 选取2021年10月至2022年10月于合肥市第二人民医院住院的T2DM患者180例为研究对象,根据是否合并肌少症将其分为对照组（n=146）和肌少症组（n=34）。比较两组患者的一般资料,采用Logistic回归分析探讨T2DM患者发生肌少症的危险因素,并建立列线图模型。结果 两组患者的年龄、病程、AGE、肌力、起立试验、四肢骨骼肌质量指数（appendicular skeletal muscle mass index,ASMI）、体质量指数（body mass index,BMI）、糖化血红蛋白、尿白蛋白/肌酐比值比较差异均有统计学意义（P<0.05）,多因素回归分析结果显示BMI、肌力、AGE均是T2DM患者发生肌少症的独立危险因素（P<0.05）;以BMI、肌力、AGE建立预测模型,经验证该模型校准度良好,具有良好的区分度。绘制受试者操作特征曲线发现其预测T2DM患者发生肌少症的曲线下面积为0.933,有良好的预测价值;校正曲线及决策曲线分析评估结果显示该模型具有更高的净收益和更好的临床应用价值。结论 AGE是T2DM患者发生肌少症的独立危险因素,对T2DM患者的肌少症诊断具有一定的预测作用。     

2型糖尿病患者骨折风险升高的机制

2型糖尿病患者的骨折发生风险较非糖尿病人群升高,但其骨密度与非糖尿病人群相比可升高或不变,因此2型糖尿病患者的高骨折发生风险主要由骨质量下降引起。引起2型糖尿病患者骨转换异常致骨折风险升高的机制包括血糖升高、晚期糖基化终末产物增加、胰岛素水平降低或作用缺陷、胰岛素样生长因子1水平降低、氧化应激和促炎细胞因子增加等,从而引起成骨细胞和破骨细胞功能异常、骨折发生风险增加。另外,某些降糖药物的应用也可导致骨折风险增加,如胰岛素、噻唑烷二酮类、钠-葡萄糖协同转运蛋白2抑制剂(sodium-dependent glucose transporters 2 inhibitors, SGLT-2i)。此外,2型糖尿病患者因低血糖发作、糖尿病慢性并发症或肌肉功能减退所引起的跌倒风险增加也可增加骨折的发生风险。